{ Psychology in Action (9e) Chapter 14: Psychological Disorders

Studying Psychological Disorders  Abnormal Behavior: patterns of emotion, thought, & action considered pathological for one or more of four reasons: statistical infrequency statistical infrequency disability or dysfunction disability or dysfunction personal distress personal distress violation of norms violation of norms

Studying Psychological Disorders: Four Criteria for Abnormal Behavior Page 476 of text

 Culture-General Symptoms: shared symptoms across cultures

 Culture-Bound Symptoms: unique symptoms that differ across cultures

Studying Psychological Disorders (Continued)  Historical perspectives:  In ancient times, people believed demons were the cause of abnormal behavior, & boring holes in the skull (trephining) allowed evil spirits to escape.  In the 1790s, Pinel & others emphasized disease & physical illness, which led to the medical model & later to modern psychiatry.

Studying Psychological Disorders (Continued)  Modern psychology includes seven major perspectives on abnormal behavior.

Studying Psychological Disorders: Classifying Abnormal Behavior  Diagnostic & Statistical Manual of Mental Disorders (DSM-IV-TR): provides detailed symptom descriptions provides detailed symptom descriptions contains over 200 diagnostic categories grouped into 17 major categories & five dimensions (or axes) contains over 200 diagnostic categories grouped into 17 major categories & five dimensions (or axes)

 Five Axes of DSM-V-TR (guidelines for making decisions about symptoms; attempts to address the ‘whole person’ ) Axis I (principal disorder needing immediate attention) Axis I (principal disorder needing immediate attention) Axis II (personality disorders contributing to the above disorder) Axis II (personality disorders contributing to the above disorder) Axis III (general medical information relevant to above disorder) Axis III (general medical information relevant to above disorder) Axis IV (psychosocial & environmental problems contributing to disorder) Axis IV (psychosocial & environmental problems contributing to disorder) Axis V (global assessment of level of functioning – how are they coping?) Axis V (global assessment of level of functioning – how are they coping?) Studying Psychological Disorders: Classifying Abnormal Behavior (Cont.)

Labelling with the DSM  While the DSM is the accepted manual for diagnosing mental disorders, there are many who argue its limitations  Biggest argument – definitions are too vague  For example:  For example: Manic depressive or bipolar Mood Disorders are characterized by dramatic "mood swings" or episodes of Mania or Major Depression.Mood Disordersmood swingsManiaMajor Depression  Is there still an advantage to using the guide?

Anxiety Disorders  Anxiety Disorder: overwhelming apprehension & fear accompanied by autonomic nervous system (ANS) arousal  Five Major Types: 1. Generalized Anxiety Disorder 2. Panic Disorder 3. Phobias 4. Obsessive-Compulsive Disorder (OCD) 5. Posttraumatic Stress Disorder (PTSD) (Discussed in Chapter 3)

Five Types of Anxiety Disorders 1. Generalized Anxiety Disorder: persistent, uncontrollable, & free-floating anxiety 2. Panic Disorder: sudden & inexplicable panic attacks

Anxiety Disorders (Continued) 3. Phobia: intense, irrational fear & avoidance of a specific object or situation

4. Obsessive-Compulsive Disorder (OCD): intrusive, repetitive, fearful thoughts (obsessions), with urges to perform repetitive, ritualistic, behaviors (compulsions), or both 5. Posttraumatic Stress Disorder (PTSD): anxiety disorder following extraordinary stress (discussed in Chapter 3) Anxiety Disorders (Continued)

Explanations of Anxiety Disorders  Psychological--faulty cognitions, maladaptive learning  Biological--evolution, genetics, brain functioning, biochemistry  Sociocultural—environmental stressors, cultural socialization

Anxiety Disorders (Continued)

Mood Disorders  Mood Disorders: characterized by extreme disturbances in emotional states  Two Main Types of Mood Disorders: Major Depressive Disorder: long-lasting depressed mood that interferes with the ability to function, feel pleasure, or maintain interest in life Major Depressive Disorder: long-lasting depressed mood that interferes with the ability to function, feel pleasure, or maintain interest in life Bipolar Disorder: repeated episodes of mania & depression Bipolar Disorder: repeated episodes of mania & depression

Mood Disorders (Continued)  Note how major depressive disorders differ from bipolar disorders on this hypothetical graph.

Explanations of Mood Disorders  Biological--brain functioning, neurotransmitter imbalances, genetics, evolution  Psychosocial--environmental stressors, disturbed interpersonal relationships, faulty thinking, poor self- concept, learned helplessness, faulty attributions

Mood Disorders (Continued)  Gender & Cultural Diversity:  Culture-general symptoms for depression (e.g., sad affect, lack of energy)  Women more often depressed. Why? Combination of biological, psychological, & social forces (biopsychosocial model) Social Psychological Biological

Schizophrenia  Schizophrenia: group of psychotic disorders, characterized by a general loss of contact with reality  Five areas of major disturbance: 1. Perception (hallucinations) 2. Language (word salad, neologisms) 3. Thoughts (psychosis, delusions) 4. Emotion (exaggerated or flat affect) 5. Behavior [unusual actions (e.g., catalepsy, waxy flexibility)]

Subtypes of Schizophrenia

 Explanations of Schizophrenia:  Biological: genetic predisposition, disruptions in neurotransmitters, brain abnormalities  Psychosocial: diathesis-stress model, disturbed family communication Schizophrenia (Continued)

Genetics & Schizophrenia

 Note the differing amounts of brain activity in the normal, schizophrenia, and depressed brains. (Warmer colors = more activity) Disturbed Brain Activity in Schizophrenia

Schizophrenia (Continued)  Gender & Cultural Diversity: Numerous culturally general symptoms, but significant differences exist in: prevalence prevalence form form onset onset prognosis prognosis

Other Disorders  Substance-related disorder (abuse of, or dependence on, a mood- or behavior-altering drug)  Two general groups:  Substance abuse (interferes with social or occupational functioning)  Substance dependence (causes physical reactions, such as tolerance & withdrawal)

Other Disorders: Substance-Related Disorder

Other Disorders (Continued)  People with substance-related disorders also commonly suffer other psychological disorders, a condition known as comorbidity.

Other Disorders (Continued)  Dissociative Disorders: splitting apart (dis- association) of experience from memory or consciousness  Types of Dissociative Disorders:  Dissociative Amnesia  Dissociative Fugue  Depersonalization Disorder  Dissociative Identity Disorder (DID)

Other Disorders (Continued)  Best known dissociative disorder:  Dissociative Identity Disorder (DID): presence of two or more distinct personality systems in the same person at different times (previously known as multiple personality disorder)

 Personality Disorder: inflexible, maladaptive personality traits causing significant impairment of social & occupational functioning  Two types of personality disorders:  Antisocial Personality Disorder  Borderline Personality Disorder (BPD) Other Disorders (Continued)

 Antisocial Personality Disorder: profound disregard for, & violation of, the rights of others  Key Traits: egocentrism, lack of conscience, impulsive behavior, & superficial charm Other Disorders (Continued)

 Explanations of Antisocial Personality Disorder Biological: genetic predisposition, abnormal brain functioning Biological: genetic predisposition, abnormal brain functioning Psychological: abusive parenting, inappropriate modeling Psychological: abusive parenting, inappropriate modeling Other Disorders (Continued)

 Borderline Personality Disorder (BPD): impulsivity & instability in mood, relationships, & self-image  Explanations of BPD: Psychological--childhood history of neglect, emotional deprivation, abuse Psychological--childhood history of neglect, emotional deprivation, abuse Biological--genetic inheritance, impaired brain functioning Biological--genetic inheritance, impaired brain functioning Other Disorders (Continued)